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在接受激进前列腺切除术的患者中,术后妄想的预测因素:一项前性研究
概括
经过激进前列腺切除术的老年患者的术后妄 (POD) 根据年龄调整的查尔森并发症指数 (ACCI),睡眠障碍,术后疼痛和感染进行预测. 一种名ogram模型有效地识别了高风险的个人,以便进行早期干预.
科学领域:
- 老年医学 老年医学
- 手术瘤学手术瘤学
- 麻醉学 麻醉学
背景情况:
- 手术后痴呆症 (POD) 是接受重大手术的老年患者的一个重大问题.
- 根本性前列腺切除与POD的显著发病率有关,影响患者的康复和结果.
- 早期识别患有POD高风险的患者对于有针对性的干预至关重要.
研究的目的:
- 分析经过激进前列腺切除术的老年患者POD相关的风险因素.
- 开发和验证用于早期识别高风险个体的预测性名ogram模型.
- 改进这种患者群体中POD的临床管理策略.
主要方法:
- 一项前性队列研究,涉及156名接受激进前列腺切除术的老年患者.
- 单变量和多变量物流回归分析以确定POD的独立风险因素.
- 开发和验证使用C指数,校准曲线和五倍交叉验证的预测性名ogram模型.
主要成果:
- POD的发生率为15.38% (24/156名患者).
- 确定POD的独立风险因素包括:年龄调整的查尔森并发症指数 (ACCI),手术前睡眠障碍,手术后疼痛 (NRS) 和手术后感染.
- 开发的诺姆图模型 (模型1) 显示出优异的诊断性能,在交叉验证后,曲线下的面积 (AUC) 为0.973和C指数为0.963.
结论:
- 在接受激进前列腺切除术的老年患者中,ACCI,手术前睡眠障碍,手术后疼痛和手术后感染是POD的重要独立风险因素.
- 开发的诺莫格拉姆模型是一个可靠和有效的工具,用于在这个特定的患者群体中预测POD.
- 这些发现支持实施早期风险分层和POD主动管理的nomogram.
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